extracellular calcium homeostasis Flashcards

1
Q

calcium and phosphate play a significant role in the formation of what

A

skeleton and teeth
regulation of biochemical pathways and signalling cascades

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2
Q

what are bones made out of

A

calcium phosphate

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3
Q

the homeostasis of plasma calcium is achieved by actions on three different hormones what are they

A

Metabolites of vitamin D
Parathyroid hormone
Calcitonin

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4
Q

what is the function of metabolites of vitamin D

A

increase calcium uptake

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5
Q

what is the role of the parathyroid hormone (calcium)

A

hypocalcaemia
acts on bones and increases resorption

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6
Q

What is the role of calcitonin

A

hypercalcaemia
wants to store calcium, moves Ca from extracellular space to be stored in the bone

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7
Q

where is the parathyroid hormone made

A

manufactured in chief cells of the parathyroid gland

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8
Q

heterozygous CaSR inactivating mutation in FHH means failure of what

A

inhibition of PTH secretion in high [Ca2+]e

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9
Q

during hypercalaemia calcium binds to what receptor
and causes what

A

GQ coupled receptors’
rise in intracellular Ca concentration -> inhibits exocytosis of PTH secretion

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10
Q

what three effects mediate numerous physiological effects

A

extracellular calcium homeostasis
nutrient sensor - parietal and G cells
enzyme secretion - alpha and beta cells

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11
Q

Where are PTH receptors expressed

A

osteoblasts in bone
proximal and distal tubules of kidneys

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12
Q

PTH is responsible for increasing

A

extracellular Ca2+

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13
Q

Bones - 1 degree primary effect
PTH stimulates _______ to recruit osteoblasts
Osteoblasts induce______

A

cytokines
osteoclasts

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14
Q

GI tract - ddegree - secondary effect
activates synthesis of 1,25-dihydroxyvitamin D and increases transcelllular uptake of Ca2+ from where

A

small intestine

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15
Q

Kidneys - 1 degree - primary effect
PTH increase ____ reabsorption by increasing activity of __________

A

Ca2+
Ca2+ channels and pumps

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16
Q

why is a thyroidectomy not fatal

A

there are small clusters of PTH producing cells outside of the parathyroid gland
trachea

17
Q

how is vitamin D converted to 1,25-dihyroxyvitamin D

A

hydroxylations

18
Q

secondary hydroxylations is regulated by

A

Growth hormone = ↑
Prolactin = ↑
Oestrogen = ↑
FGF23 = ↓
1, 25-Dihydroxyvitamin D = ↓

19
Q

what is the primary role of 1,25 dihydroxyvitamin D

A

contribute to homeostasis of calcium

20
Q

how does dihydroxyvitamin D contribute to homeostasis in the small intestine

A

increases calcium absorption

Diffuses into enterocytes and binds to vitamin D receptor (VDR) and increases gene expression
Increases calcium transport across the enterocyte membrane by increased expression of apical Ca2+ channels and basolateral Ca2+ transporters.

21
Q

how does dihydroxyvitamin D contribute to homeostasis in the kidneys

A

increases expression of Na+-Pi cotransporter
improves PTH-mediated Ca2+ reabsorption

22
Q

how does dihydroxyvitamin D contribute to homeostasis in the bone

A

increases number of osteoclasts

23
Q

where is calcitonin manufactured

A

clear cells of the thyroid gland

24
Q

what does calcitonin respond to

A

hypercalcaemia

25
what is an antagonist action of PTH
calcitonin
26
owhere in the bone are there calcitoonin receptors
osteoclasts
27
how does calcitonin act on the bone
reduces rate of bone turnover, forcing release of Ca2+ in the bone
28
testosterone maintains what in calcium homeostasis
bone density
29
what do glucocorticoids do in calcium homeostasis
decrease maintenance and abundance of osteoblasts but increase number and function of osteoclasts
30
Fibroblast growth factor 23 (FGF23) is secreted by what
osteocytes
31
Fibroblast growth factor 23 (FGF23) production is upregulated when
plasma concentrations rise
32
Fibroblast growth factor 23 (FGF23) stimulates phosphate loss where
in the urine
33
what is hypoparathyroidism
lack of PTH
34
what is hyperparathyroidism
excess of PTH from parathyroid glands
35
what is the primary cause of hyperparathyroidism
tumors
36
what is a secondary cause of hyperparathyroidism
chronic kidney disease (lack of 1,25 - dihydroxyvitamin D calcium malabsorption